Red Stick Recovery LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

RED STICK RECOVERY LLC

Doing business as

Red Stick Recovery

Practice address

856 Highway 90 Ste D
Bay St Louis, MS 39520-2737

Phone

(228) 215-0255

Fax

(228) 215-0255

NPI assigned

Mar 5, 2024

Organization subpart

Yes

Parent organization

RED STICK RECOVERY LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kaley Benson, RN

Title

Chief Executive Officer

Phone

(228) 215-0255

Specialties & licenses 1

Addresses

Other names 1

• Red Stick Recovery Doing business as

Tax ID family

Red Stick Recovery LLC2 organizations share this tax ID, including this one

Part of

Red Stick Recovery LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Red Stick Recovery LLC

  • Community/Behavioral Health Agency
  • Baton Rouge, LA
  • NPI 1619758034
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian K Benson, M.D. PH.D.

  • Addiction Medicine (Family Medicine) Physician
  • Baton Rouge, LA
  • NPI 1558621821
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1336906478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 GREENMEADOW DR",
            "city": "GREENWELL SPRINGS",
            "state": "LA",
            "postal_code": "707394102",
            "telephone_number": "225-978-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 HIGHWAY 90 STE D",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395202737",
            "telephone_number": "228-215-0255",
            "fax_number": "228-215-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED STICK RECOVERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RED STICK RECOVERY LLC",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "KALEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "228-215-0255",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Stick Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise Elaine Powell, MD
• Matthew L Powell, D.C.
• William L Powell Jr., D.C.
• Erin Quave, RD
• Angela Rainey
• David Millard Rimmer III, M.D.
• Amanda Ring, LMSW
• David Robertson, RN
• Jared Y Robertson III, CRNA
• Root and Realign, LLC

• Medical Specialty Clinic/Center in Bay St Louis, MS
• Providers in Bay St Louis, MS by specialty
• Medical Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.